Doctors from El Salvador link with Norwalk

Published
8:00 pm EDT, Wednesday, May 28, 2008

NORWALK

By JILL BODACH

Hour Staff Writer

Jorge Ernesto Mejia Corletto and Jose Mauricio Gonzalez Campos have already earned their medical degrees, but for the last two weeks they've played the role of students once again as they shadowed doctors and residents at Norwalk Hospital.

Corletto and Campos are the first doctors from El Salvador to visit the U.S. as part of the Glasswing International exchange program. The Glasswing International nonprofit organization was founded by former Common Councilman Ken Baker.

Corletto and Campos, doctors at Rosales Hospital in San Salvador, are the first Salvadoran doctors to visit the U.S. to observe medical practices and share ideas about patient care.

Rosales is a Level One, government-funded hospital built 107 years ago and is the main referral hospital in the area. Its doctors primarily handle internal medicine and surgery and do not deal with other specialties, including ob/gyn and pediatrics.

In mission, Rosales Hospital and Norwalk Hospital are very similar: Help sick people get well. In practice, the two hospitals differ greatly as well.

One difference is that in El Salvador, there is no standard of care between hospitals, or even doctors.

"A lot of the clinical care here (Norwalk Hospital) is directed by protocols and standards of care, but we don't use that at home," Corletto said. "Doctors can find several ways to treat the same type of patients, and, with no standard of care, they are free to do what they think will work best."

Campos and Corletto said they would desperately like to standardize care in Rosales Hospital.

"This is a real weakness of our system," Campos said.

At Rosales, the technology is very limited, another difference between the two hospitals.

"Although we have similar knowledge and expertise in our country to the doctors in this country we are limited by the resources we have," Corletto said.

"We don't manage our patients with digital charts like doctors do here," Campos said. "Our charts are all handwritten. I have a strong desire to improve our chart system and possibly have a computer in every unit."

Yet another difference is the limited availability of certain medical tests like echocargiograms and pharmaceutical medications at Rosales that are readily available in the U.S.

Doctors at Rosales are also more limited with what they can provide to patients, particularly those who cannot afford payment. While access to health care is a critical issue in the U.S., it is even more critical in some respects in El Salvador.

"From what I saw when I was there, if you don't have any money there are certain tests you just can't get, like a cardiac catheter," said Dr. Mark Kulaga, an internal medicine practitioner at Norwalk Hospital. "Here, we care for patients whether they can pay for it or not. If a cardiac cath was deemed medically necessary, we'd do it."

Kulaga, one of the doctors who visited Rosales Hospital earlier this year, said he was most impressed with the way the doctors at Rosales didn't let the challenges they face affect the way they care for and interact with their patients.

"I was very impressed with the excellent bedside skills of these doctors," Kulaga said. "They are able to spend more time with patients than we are here."

Corletto and Campos will return to El Salvador on Saturday and said they will take will them many lessons learned here.

"Our experience here has been amazing for us because the American health care system is really a paradigm for us so seeing how that system works has been wonderful," Corletto said.